ENGAGEMENT OF YOUNG PLHIV & YKPs AT POLICY AND DECISION MAKING LEVELS

CAPACITY BUILDING WORKSHOP

The APLHIV is collaborating with Youth LEAD [a regional youth organization in Asia, Pacific Region] to empower the Young people Living with HIV [YPLHIV] & members of Young key Populations [YKPs] in Pakistan. This collaboration started in March 2014 under a small scale project. The project aims to create enabling and empowering environments to enhance the engagement of YPLHIV and YKPs in Global Fund Processes, with a special focus to synthesize and generate strategic information in relation to HIV and Young people, to ensure that youth have the skills and knowledge to influence the the policies and decisions about their future and ensure that in HIV response programming especially in the grants of Global Fund, the youth is engaged as an equal partner.

The project is divided into three phases/components, which are as appended below: –

1. Rapid national Assessment of Needs of YPLHIV and YKPs in Pakistan

2. In country capacity development trainings on Global Fund and New Funding Model.

3. Establishment of Youth Chapter and Advocacy activities.

The APLHIV-Pakistan has successfully completed the “Rapid Assessment at National level” and the report was launched on 26th August 2015 in presence of over 50 stakeholders from across the country. The APLHIV also successfully launched the Y Chapter on 26th August 2015, which has received an acceptance by all the provincial and national stakeholders.

The capacity building component is in process and the 1st training workshop was held after the launch of Y chapter from 26th to 28 August 2015. Over 15 participants from across the country attended the training workshop. The workshop focused on following areas: –

1. Know your epidemic.

2. Know your response.

3. Know your National Strategic Frame work

4. Global Fund, its background, structure at global and national levels, objective and principles of funding.

5. New Funding Model, its characteristics and processes.

6. Know your Country Coordinating Mechanism [CCM]

7. Meaningful engagement of youth in Global Fund related issues

8. Importance of youth for the Global Fund grants

9. Way forward.

The participants contributed proactively in the workshop. A training manual covering all above subjects was developed in local language [Urdu], Power Point slides in Urdu were also used. Every lecture was followed by a group work and group presentations. The participants declared the training session as useful activity. Same activities shall follow soon in Lahore and Karachi.

DRUG USER’S TRAINING ON FUNDAMENTAL AND HEALTH RIGHTS & ADVOCACY SKILL BUILDING

Background

Narcotics and Drug control movement initiates from a desire to save human being from harm and to save the lives. Therefore the international community seems to be motivated to prohibit a series of Drug substances and establish measures to eliminate their production, distribution and consumption. The primary phrase of the 1st UN Treaty on Drug control-1961, also speak of concerns for the health and wellbeing of humanity. In 1998, the UNO initiated a move and rose a slogan “A Drug Free World, We can do it”, but with little gains. Cannabis use in USA and New Zealand is higher than any other country, Where as Afghanistan occupies top slot in production of opium, which is above 85% of total global production. More than 30 Countries across the globe retain capital punishment for Drugs; however international conventions treat capital punishment as human rights violation. But still many countries continue to retain the capital punishments with varying degree of its execution/implementation. Drug is being used with various modes, which also keeps changing very often, but one the major mode is to “Inject Drugs”. Various Research studies confirm that HIV and Hep-C prevalence in Injecting Drug Users is alarming and high. In Pakistan HIV prevalence in IDU is over 37% whereas Hep-C is over 95%. Some Drugs like Methadone and Buprenorphine are included in the model List of Essential Medicines 2005; however in some countries the use of such drugs for treatment is still illegal. Harm Reduction is a philosophy whose aim is to reduce the harms of Drug use. By 2008, approximately 77 countries implemented/tolerated some form of harm reduction & 63 had substitution Treatment. It is worth mentioning that by end 2013 there were over 60 Million People Injecting Drugs across the globe out of which 3 Million are HIV+. IDUs are highly Vulnerable to TB infection which is 6-10 times higher than general Population. Geographically Pakistan is bordered with Afghanistan on its Northwestern and western side.  Afghanistan is the world’s largest producer of illicit opium and places Pakistan in a vulnerable position in term of Drug trafficking as well as Drug abuse.

Drug Use And Law In Pakistan

Pakistan is a Federal Republic exercising parliamentary democracy with four Provinces, Three semi-autonomous regions, capital territory of Islamabad and FATA. The legislative powers are vested with parliament (National Assembly and Senate) and respective provincial / regional assemblies. The president of the country is constitutional head and ceremonial appointment, where as the Prime Minister is the head of Government. The constitution was promulgated in 1973 and is enforce till date with many amendments. The constitution of Pakistan bases itself on Islamic Principles. The preamble of the constitution proclaims Islamic Principles of social justice, declares respect for fundamental human rights, status of equality, opportunity and protection of law within an egalitarian socio-economic order. The constitution guarantees the preservation of life, liberty, body and property of each person. The state cannot prevent or hinder a person from doing something not prohibited under law and cannot compel a person to do something that is not required under law. Constitutional protections afforded to persons within justice system include the right to legal representation, defense and procedural safeguards during detentions and arrest.

The constitution itself requires all laws to be brought in conformity with Islamic injunctions. Islamization of law started in 1979 with introduction of new legal code and promulgation of Hadd ordinance. Hadd order 1979 contains four (4) ordinances dealing with offences against; (1) Property, (ii) Adultery (Zina) & Rape (Zina-bil-jabr); (iii) Qazf (false accusation of Zina) and (iv) Prohibition of intoxicants. The Hadd order explains the procedures involved, manner of investigation and the punishments. Punishments provided under Hadd order include flogging, imprisonment, fines, stoning to death and or capital punishments. Execution of these penalties requires conviction to be confirmed by Shariat Courts and or Federal Shariat Court. In 1991 Shariah Act-1991 was enforced to instill Islamic values into legislative and Judicial regime. The Judicial system of the country consists of Districts Courts, special Courts / tribunals, session Courts, High Courts and Supreme Court. The Supreme Court is the highest judicial authority. The decisions of the Supreme Court are final and binding. Cases related to Hadd order are heard by Shariat courts. The system/chain of Wafaqi Mohtasib and under command institutions is also working. In addition 2 ANF Acts are also in place dealing with drugs.

Issue

The literacy rate as a whole at the National level is very low and it is even lowest in marginalized populations. This low level of literacy leaves the members of marginalized population with no knowledge about their fundamental human rights and rights to access the health services. The situation is even worst in Drug user’s community who are subject to arrests, detentions and with limited access to legal support system due to lack of knowledge.  Keeping the same in mind the APLHIV under the project “Access of Drug Users to Fundamental Human and health Rights” supported by INPUD and Mainline under took a campaign to educate selected members of Drug user’s community about their Fundamental Human and Health Rights. Approximately 390 members of the community were educated on the subject matter.

Objective

To provide basic awareness to our PUD community members about their available rights under the law of the land and capacitate them about fundamental human right issues as well health issues.

Highlights/Summary of the Activity

  1. The activity was conducted in seven [7] cities across the country.
  2. Invitation was sent to all expected participants from within PUD community involving relevant CBOs and government institutions with a minimum education level of Metric.
  3. Presentation and IEC material was prepared both in English and Urdu languages, printed in form of booklets and used during the training. Each participant was provided with IEC material.
  4. The awareness campaign was conducted in Local language (Urdu).
  5. The participants were provided with basic information on the rights available to them under the law of land and their implementation level. Hepatitis, its types, mode of transmission, prevention and available treatment was also discussed during the session.
  6. The information was given with help of presentation, charts, clip boards and posters.
  7. Answer/question session was conducted.
  8. In addition to the community members, ORWs from within community were provided with required basic knowledge.

The community members were asked about their basic issues and a suggested way forward, this information shall be useful while prioritizing the advocacy plan.

Advocacy Skill Building Workshop

Selected community members and expected members of steering committee of DUNE were provided intensive training for two [2] days in Islamabad about Advocacy skills. The focus was to enable the members of the steering committee to carry out advocacy for their issues, which is one of the major objectives of the DUNE. Ten [10] members of the steering committee of the DUNE attended the workshop. The workshop followed the module of lecture, presentation, group work, group discussion, exercises to identify the issues, make advocacy plan and the techniques involved to undertake advocacy.

“THIS IS HEPATITIS-KNOW IT – CONFRONT IT”

HCV AWARNESS CAMPAIGN BY APLHIV

Background

Pakistan is currently facing an epidemic of viral hepatitis in the country with rapid spread of both Hepatitis B and C in the community. Pakistan Medical and Research Council conducted a national prevalence survey in the country to ascertain the prevalence of Hepatitis B and C in the country in 2007. Of 47043 persons screened, the HBsAg prevalence came as 2.4% (95% confidence interval of 2.3-2.6) and anti HCV 4.9% (95% confidence interval of 4,7-5.1), making an aggregate of 7.4% thus showing HBV & HCV exposure in about 12`million population. HBV provincial prevalence showed HBV figures of 2.5%,2.4%,1.3% and 4.3% in Sindh, Punjab, NWFP and Balochistan respectively, while figures for HCV were 5%,6.7%.1.1% and 1.5% in Sindh, Punjab, NWFP and Balochistan respectively.

Among the affected population certain risk groups have much higher concentration such as people who use drugs [PWIDs]. The infectivity of Hep –C is much higher than HIV, leading to very high prevalence of Hepatitis in People Living with HIV especially PWIDs. Co-Infection is complicated to manage and difficult to treat. The treatment is highly expensive, which is almost unaffordable for the co-infected PLHIVs. The available treatment includes “Interferon”, “pegylated Interferon” and “Ribavirin”. The side effects are very common and severe, thus forcing many patients to quit the treatment. With introduction of new medicines to treat Hepatitis C such as Sofosbuvir (Sovaldi) the cure rate has drastically improved but the very high cost of this medicine is simply prohibitive for its widespread use in PWIDs.

Because of very high disease burden of Hepatitis in the country, Pakistan launched the first Hepatitis Control Program in the country in 2005 (Prime Minister Program for control of Hepatitis in Pakistan). Under this program emphasis was laid on both prevention and treatment of Hepatitis B and C patients in the country. After Devolution all provinces are now running their own provincial hepatitis control programs.

Although treatment services are available in the provinces but availability of these services is limited and with no information available to HIV community on how to access these services. There is minimal coordination between Hepatitis programs and National/ Provincial AIDS Control programs.

Treatment of Hepatitis B and C is critical in PWIDs because the course of infection of Hepatitis is much accelerated in PLHIV co-infected with Hepatitis leading to very high rates of liver cirrhosis and hepatic carcinoma. Therefore in order to reduce hepatitis C related morbidity and mortality and to ensure that the investment on ARV is not wasted. It is worth mentioning here, that the Hep-C is treatable and curable disease. The rapid development of new highly effective interferon-free treatments for hepatitis C will significantly change the landscape of hepatitis C treatment around the globe. Gaining rapid access to newly developed and proven treatment, sofosbuvir (an oral nucleotide analog polymerase inhibitor) [Gilead – Sovaldi] will be vital to minimize the longer-term side effects which will lead to reduce the Hep-C burden.

Issue

Despite of the fact that Pakistan stands 2nd to Egypt with regard to HCV infection in the globe, but ironically very less awareness exists about this epidemic in the country. Things are worst with in HIV community and PWIDs. Lack of awareness is one of the major contributing factors for new HCV infections and HIV/HCV Co-Infection. The investment in HIV treatment, care and support services has dramatically increased the quality of lives, but this investment may be in danger as the HCV co-infection has already become the leading cause of deaths in HIV community. Keeping the scenario in mind the APLHIV took an initiative to educate selected community members on basics of HCV, HIV/HCV co-Infection, its management and treatment. The initiative was supported by the APN+. The APLHIV conducted seven [7] awareness sessions across the country to educate the community members on HCV and associated issues. Available basic information was collected and published in Urdu and English in form of booklet which is available with APLHIV. Over 375 selected community members were trained on the subject matter from across the country.

Objective Of The Awareness/Training

To provide necessary skills and basic knowledge to HIV Community about HCV, HIV/HCV co-infection, related issues and its management with an objective to create awareness about Hep-C in the community.

Highlights/Summary of The Campaign

1. Awareness campaign was undertaken in seven [7] different cities.

2. Invitation was sent to all expected (390) participants from within HIV community with a minimum education level of Metric.

3. Presentation and IEC material was prepared both in English and Urdu languages, printed in form of booklets and used during the training.

4. The awareness campaign was conducted in Local language (Urdu).

5. The participants were provided with basic information on Hepatitis, its types, mode of transmission, prevention and available treatment.

6. Special focus was given on Hep-C, mode of transmission, prevention, tests, treatment, HIV/HCV Co-infection and its Management.

7. The participants were also given awareness about available treatment, expected side effects of treatment, Advantages of the treatment and Healthy tips.

8. The information was given with help of presentation, charts, clip boards and posters.

9. Answer/question session was conducted.

10. In addition to the community members, ORWs from within community were provided with required basic knowledge.

The phase I of the campaign was undertaken to educate the community members, whereas in Phase II 350 PLHIV were tested for HCV through Elisa testing kits which has an accuracy of around 99%. 95.41% respondents were found HCV+. Detail report is available on this website under Tab “Reports”. Phase II was also supported by the APN+. We thank UNAIDS, NACP and PACPs for their support during the entire process.

FIVE (5) DAYS TRAINING WORKSHOP ORGANIZED BY THE APLHIV ON ODMG

The Association of People Living With HIV (APLHIV), the nationwide network of the HIV community in Pakistan conducted a five days training workshop in collaboration with National AIDS Control Program (NACP) and with technical assistance of UNAIDS from 28th Jan to 1st Feb 2013 in Islamabad. The training workshop was part of series of training and Advocacy meetings across the country, under the Global Fund Round-9 Project. Continuing with the goal to strengthen the community, the Management of APLHIV conducted this workshop with an objective “to strengthen civil society and foster institutional capacity building on care and support for PLHIVs”

This 5 days training workshop inaugurated by Dr Salman Otho focused on the acquisition of practical skills and shared understanding of the concept, practice and principles to effectively work within a Right Based Approach. The topics covered include Organizational Development, Management and governance, Planning, Community linkages, Advocacy, Monitoring and Evaluation and Gender/human rights. The training workshop was designed for middle and upper level staff of the NGOs, CSO and CBOs working for HIV community across the country.

Over 35 participants from over 20 organizations attended the training session. During the session group work, self help and problem solution exercises were conducted in addition to the formal presentations and lectures. The closing ceremony was chaired by Mr. Marc Saba, country coordinator UNAIDS for Pakistan and Afghanistan as chief guest who also distributed the certificates and souvenirs among the participants. While addressing the closing ceremony the chief guest admired the standard of the trainings and the activities being under taken by the APLHIV. He emphasized for a collaborative work for the uplift of the community and to address the challenges faced by the community. He extended an extra and special word of gratitude for the APLHIV to come a long way in short span of time to organize such an event

NATIONAL CONSULTATIVE WORKSHOP ON ROLE OF CBOS ORGANIZED BY THE APLHIV

The Association of People Living With HIV (APLHIV), the nationwide network of the HIV community in Pakistan conducted a consultative workshop in collaboration with National AIDS Control Program (NACP) and with technical assistance of UNAIDSon 31stJan 2013 in Islamabad. The consultative workshop was part of series of training and Advocacy meetings across the country, under the Global Fund Round-9 Project. Continuing with the goal to strengthen the community, the Management of APLHIV conducted this workshop with an objective “To develop a framework on the role of PLHIV organizations“

This one day consultative workshop focused on “to orientate the participants of the role currently being practiced by the PLHIV Organizations and develop consensus on the role they need to play with specific emphasize on the role of the APLHIV (the national network)”.The workshop was organized in two parts; in part one the attendees were acquainted about the role currently being played by the NGOs working in the HIV community. Whereas in part two open discussions were held identifying various challenges being faced by the community and to make an effort to unify the work for the community.

Over 38 high level delegates including the heads of various NGOs, Chiefs of Provincial Aids Control programs and high ranking official of public sector attended the workshop. Competent, beneficial and useful contribution was made by the participants.

The session was chaired by Dr.Saleem from UNAIDS. The chair in his opening address appreciated the effort of the APLHIV to gather major role players under one roof. He emphasized the need to explore the possibility to determine the future of the community by working together in collaboration and in solidarity. He hoped that the role of the APLHIV shall be mile stone to take out HIV&AIDS from isolation and tagging it into social movements. The closing ceremony was chaired by the SPO GFATM Dr.Salman Otho. At the end the chair gave away the certificates to all the participants. All the participants highly appreciated the effort of the APLHIV.

 THREE (3) DAYS ADVOCACY WORKSHOP ORGANIZED BY THE APLHIV

The Association of People Living with HIV (APLHIV), the nationwide network of the HIV community in Pakistan conducted a three days advocacy seminar for the HIV community in Pakistan from 25th to 27th Feb 2013. The seminar was for representatives from National and Provincial Social Welfare and human rights Departments, Ministry of Religious Affairs, Ministry of law/ Justice, Ministry of Human Rights, Ministry of Information, Ministry of Education and Ministry of Narcotics control to build their Advocacy skills and orientate them for their role for the empowerment of the HIV community in Pakistan.

This 3 days training workshop focused on “concept of Advocacy, role of above mentioned stakeholders, outlining the activities to be carried out for Advocacy and social mobilizations, analysis of failed and successful Advocacy campaigns and designing the Advocacy strategies”. Basic information/review of the epidemic was also given to the attendees.

Over 40 participants from above mentioned Federal and Provincial Ministries/ organizations attended the seminar. The session was inaugurated by UCC Pakistan & Afghanistan Mr.Marc Saba.  During the session group work, self help and problem solution exercises were conducted in addition to the formal presentations and lectures. The session was also visited by the Secretary of the Federal Ministry of Law & Justice. Various high level government delegations also visited the venue during the seminar. The closing ceremony was chaired by Dr.Qazi Mujtaba, head of the National Aids Control programe (NACP) as chief guest who also distributed the certificates and souvenirs among the participants. While addressing the closing ceremony the chief guest admired the standard of the trainings and the activities being under taken by the APLHIV. He extended an extra and special word of gratitude for the APLHIV to come a long way in short span of time to organize such an event.

DATA COLLECTOR’S TRAINING UNDER REGIONAL (MULTI COUNTRY) RESEARCH BASED GFATM ROUND-10

The Data Collector’s Training was conducted in Islamabad from 10th October 2012 to12th October 2012. The training was attended by 11 data collectors from across the country. A team of the APN+ also attended the training session to observe the event. The APN+ team was highly impressed by the conduct of the activity. The activity was also visited by the NPM-NACP and other high delegates from government and private sector. The training focused on giving skills to the participants on techniques of data collection. The participants represented multi sartorial and gender from across the country.